Saturday, May 25, 2013

Cultural Differences: Healthcare: In Which MsCaroline Tries A New Position

(Warning: This post describes - although somewhat obliquely - an actual medical examination performed on MsCaroline which she felt would be of interest to her (mostly female) readers. Male readers - and those who prefer not to think about such things - should probably skip this one.)
Although MsCaroline has been extremely preoccupied recently with finding somewhere to live, she has also had to keep up with the everyday and the mundane: work, children, housecleaning, laundry, cooking, shopping. Included in this have been a few regular - but not as mundane - personal maintenance activities and exams: mammograms, dental cleanings, and, of course, every woman's favorite - a trip to the gyno.

One would think that MsCaroline, as a woman of mature-ish years with two deliveries (and plenty of observers at each) behind her, would have discarded any shreds of remaining dignity long ago, and be absolutely sanguine about displaying her, shall we say - charms - to any qualified medical professional without a second thought.

Oddly enough, that is not the case.

Perhaps it is MsCaroline's puritan conservative New England upbringing. Perhaps it is the result of having delivered (naturally) a baby with a head roughly the size of a soccer ball which causes her to instantly react to being placed in the lithotomy position with a certain amount of panic. Perhaps it is a reaction to all those nude beaches when she lived in Europe. Whatever the reason, MsC views her annual check of the undercarriage with the same amount of trepidation that most people would have for an unanesthetized appendectomy, or perhaps a spinal tap.

She is fully aware that there is no good reason for this, which is why she gives herself several stern talkings-to every spring in order to shame herself into Doing The Responsible Thing and making an appointment for an annual exam.

This was difficult enough in the US, where everyone spoke English and her physician was a kind and gentle soul who efficiently distracted MsCaroline from the business at hand by discussing Labrador Retrievers every time she appeared in his office.

When MsCaroline moved to Seoul, though, she realized that she would be facing a bit of a challenge, since gentle English-speaking, retriever-discussing gynecologists are on thin ground here.

Her solution? Put it off for as long as possible, which she did. And, with one thing and another, a few years slipped by.

Of course, MsCaroline - while mostly irrational and paranoid - does not have an actual death wish, which means she eventually talked herself into making an appointment at the local hospital, which serves many international patients and which she had visited herself for other, less intimate health issues with great satisfaction.

What transpired was an exam fairly similar in procedure and comfort to the ones she experienced in the US, with an exception that she had absolutely not forseen: the examining table. Or, rather, the examining chair.

MsC, who has only had this sort of thing done in the USA, has no idea how it's done in other countries, and she is well aware that there is something of a consensus in the international community that Americans are wusses when it comes to issues like privacy and dignity and comfort as they relate to medical procedures. So she was not too surprised when, after a brief consultation with the doctor, she was walked around the corner of the office, ushered into a cubicle with a curtain that did not close, and told to change into the provided garment while three medical personnel (2 nurses, 1 physician) watched her do so.

When she emerged, she was ushered to what looked pretty much like a pink dentist's or optometrist's chair that had sort of cushiony thigh-rests for one's thighs. MsCaroline's thighs were, however, still together, and she was still modestly draped, which, to her mind, would not be useful for the sort of examination she was anticipating. She sat there in the upright position, face-to-face with the doctor, who was sitting at eye-level on a low stool opposite her, flanked on either side by nurses, all of them staring expectantly at her, and wondered, How in the world will this happen? Is she going to get down on her knees? Maybe I should be standing up? Or maybe I'm supposed to lift my legs up in the air? What is the protocol here?

(For non-US readers. MsCaroline should clarify that the typical position for such examinations in the US is a sort of a raised table with foot stirrups at one end. The patient lies down, (usually covered in both a gown and some sort of paper modesty drape) places feet in the stirrups, does some scooting, and the physician approaches the end of the table to do his or her thing. It is a position of great indignity, but it is one with which MsC is at least familiar. At this point in time, she would have welcomed such a situation, because at least she would have understood what her role was.)

In this case, however, what transpired was something that took MsCaroline by such surprise that the examination was almost over before she had a chance to reflect upon her loss of dignity.

As the doctor and nurses all looked on, MsCaroline's chair began to transform beneath her. Before she had a chance to register what was happening, the chair began to rise, while simultaneously reclining. At the same time, the thigh-rests (which MsCaroline had initially perceived as cushions) revealed themselves as thigh stirrups, and began spreading inexorably outward as the seat of the chair dropped away, leaving MsCaroline in what can only be described as a compromising position in mid-air. (MsCaroline should note here that, even in her state of shock, she was cognizant enough to observe bitterly, Well, at least there aren't any automatic wrist and ankle restraints to complete the picture.) Even stranger, instead of being flat on her back and able to focus on a spot on the ceiling (Dear God, please make me a bird, so I can fly far, far away. Dear God, please make me a bird...), MsC was still upright enough to be making eye contact with her audience of three, all of whom were staring raptly at her splayed business with terrifying intensity.Mercifully, one of the beauties of Korea -and the Korean medical system in particular - is that people here are in a hurry, and they do things fast. No sooner had MsCaroline's Very Slow Cognitive Processes identified an irregularity (Hey...what the-) than the doctor was pushing the magic button that returned MsCaroline to an upright - if somewhat traumatized - position.

By the time she had dressed and hustled herself back out to the doctor's consulting room, it was almost as if the whole thing had never happened.

And that is probably for the best.

(Note: MsCaroline - although a wussy American - should point out here that, while the position for being examined was quite different, the examination itself was thorough, appropriate, comfortable, and left her feeling, once again, that the Korean medical system is really pretty damn excellent. The next time she goes, she will know what to expect. She is particularly interested in knowing if any of her readers have experienced this sort of thing. Or, perhaps it is the norm in most other countries?)

16 comments:

I LOVE YOU! This is the funniest thing I have read in a very long time. I can just imagine the shock on your face as the chair moved you into position! I have only ever done the needful in the US, Malaysia and Paris and I can tell you that they all involved tables and stirrups and scooting down. Although my US doctor has now taken to giving me a paper vest (open to the front, please!) and a paper sarong to wrap around my waist, skirt-like. Neither is big enough to cover my whole modesty.

I have to disagree about there not being any good reason for trepidation! Private parts are called that for a very good reason and we have every reason to be fearful when asked to put them on display. As my father says, if God had meant for us to run around naked, he would not have created wicker. To which I would now add thigh-splaying examination chairs.

Stacy - yes, I was shocked - in fact, I started laughing - which only made the whole scene even more surreal and probably confirmed my insanity in their minds! In Korea, they do the gyn exam separately from the breast exam (I went to a different place altogether for a mammogram, which was so mundane it wasn't worth writing about) so you keep your top on and just slip on this crazy elastic-waist skirt. It's actually great - cloth, not paper,nice and roomy and wide, and the thing is almost down to your ankles. I would have had no problem walking down the hall in it (well, it was ugly, but it covered me.) I would definitely take that any day over the inadequate paper stuff every other doctor in the world seems to keep in stock. As far as private parts go - here in Korea, there is a faaaar different sense about what is and is not 'private' - from the fact that your doctor will discuss anything and everything with you out in a hall or reception room to the fact that everyone walks around starkers in the Korean saunas and bathhouses. Of course, I also work with all Germans, who have a similar approach to the concept of 'private' - their take on things is a lot more relaxed than you will find in America. I have come to realize just how uptight I am in these past 2 years, despite having romped topless on European beaches in my high school and college years (I was living in Germany then) without giving it a 2nd thought. Of course, my 'business' was in slightly better shape back in those days as well, so maybe that's why! I completely agree with your dad - he sounds like a wise man!

Emma - Yes, I've seen those chairs, but never one that moved around like a transformer! I'm very glad the whole experience is behind me. Crossed fingers that I won't have to do it again til I get back to the US!

AA - You're right, that aspect is significantly more efficient. I hate the scooting, and they're always telling you to come further down, when your common sense tells you your bum's about to fall off the table!

What a fabulous post. Must share with my husband but,be reassured, purely on a technical basis!! Don't worry, he has seen enough undercarriages to last him a lifetime but will be intrigued by the chair.

Trish - MrL (an engineer by training) was also intrigued by the chair! We both did some hilarious speculating that evening (over a beer, which I felt I'd earned) about the sub-type of individuals out there in the world who would probably love to have just such a chair in their home for private use. (I can tell you, when I was Googling to try and find a photo of one of those chairs to include in the post, the hits I got were pretty alarming!) People are always telling me that physicians see so much of this stuff it's all old hat to them, but when it's one's own undercarriage in question, the whole situation feels slightly different...; )

Rainbow: Thanks. I'd like to think that there may just now be one western woman out there who will be better prepared for her Korean gyno visit, thanks to me. At the very least, she won't be quite as surprised as I was...

Yet another example of how we are out of date in the UK (at least, in most doctor's surgeries that I know of). Our extremely modern and technical equipment consists of - wait for it - a padded bench (you know the type of thing). No stirrups, no reclining seat, no thigh-separators (or whatever). Just the bed, if you're lucky a warm tap to make the equipment less perishingly cold, and an instruction to drop your knees apart. Oh, the glamour!

Oh my. I must share my experiences here in Shanghai! (It'll get it own post as I'm scheduled for a hysterectomy first week of July so I've got lots of material) but I'll just give you the highlights of my first exam... no dressing curtain to disrobe behind, no cloth (paper or otherwise) to cover up with, business end of my body facing the door, and a steady stream of people who'd give just the briefest of taps on the door before entering, leaving door open to have a conversation with my doctor. It was so horrifying and surreal that all I could do was laugh and pretend I was starring in a bad comedy back in the heyday of Chevy Chase and that the sacrifice of my dignity for comedy would be worth it somehow and I'd win, if not an Oscar, then at least a Golden Globe for my efforts. *sigh* Thanks for sharing!

Oh, Heather, it *does* sound like a surreal nightmare - very similar to my own, although I had a curtain (didn't close) and only an audience of 3 staring at me. As far as drapes go, they give you this elastic-top skirt, but it doesn't actually cover anything because it hikes up around your waist when the chair opens up. I did have sort of a hysterical outburst of laughter when the chair started metamorphosing - 50% hysteria, 50% realization of just how unbelievable the whole situation was. I'll be looking forward to hearing all about it - and I will just pass on that every. single.person I know who has had a hysterectomy has reported that they'd wished they'd done it long ago because they didn't realize how bad they'd been feeling until after their surgery, when they started feeling better. Sending you hugs and healing thoughts - and reallly looking forward to that post! ; )

Search This Blog

Mr. Logical, Bangkok, 1974

"We've spent our whole lives moving. How hard can it be?"

By the time my husband and I were married, our military/diplomatic childhoods had resulted in a combined 30-plus moves between Asia, Europe, and the continental United States. Our plan was to raise our children in one place, giving them the stability we had never experienced. We lasted for 8 years (the longest either of us had ever lived anywhere) before our first cross-country move.

When the possibility of a transfer to Seoul came up, we jumped at the chance to live and travel in Asia again without thinking much about the gritty realities involved in an international move and the logistics of relocating our two non-expat kids. After all, we'd both moved numerous times, right? We'd both lived in Asia, right? How hard could it be?

What was supposed to be a 2-year assignment turned into a 4-year assignment, and one short stint overseas turned into another international move.